PINELLAS COUNTY, Fla. — As families work to rebound from the pandemic, one Pinellas County family found themselves fighting a huge rate increase in their Florida KidCare Health Insurance.
Florida KidCare is the state's children's health insurance program for uninsured children who meet income and eligibility requirements from birth all the way through age 18. Florida KidCare also includes Medicaid for children and helps millions of uninsured children each year get access to coverage.
Many families pay nothing at all and other families pay as little as $15-$20 per month for KidCare coverage.
Leigh Anne Stanton is a small business owner in Pinellas County. Stanton has always qualified for subsidies through the program, guaranteeing her a lower rate. However, when she got her eligibility letter from the state a few weeks ago, it said said her rate had increased substantially, jumping from $20 per month to more than $400.
“I just couldn't believe what I was reading,” she said.
Stanton said she got a slight raise and that alone eliminated her eligibility for subsidies that kept her rates low. So instead of $20 per month, she now had the full pay amount, which was hundreds more.
“You can't even win,” she said. “So now, I have to pay more just because I made a little bit more, you know, even through all this pandemic."
The Family Healthcare Foundation is a Tampa-based non-profit that helps families apply for low-cost or no-cost coverage through the health insurance marketplace, medicaid and more.
Melanie Hall, who serves as executive director, said Stanton’s situation is not unique and that this is happening to hundreds of Florida families each year.
“You want families to be able to continue to increase their income and move along in their careers, but not at the expense of losing coverage for their children,” Hall said.
Hall said some states are already making changes to their own state-based health insurance programs for children, allowing families to make more money and still qualify for subsidies, and therefore lower insurance rates.
This comes as House Bill 201 and its companion, Senate Bill 1244, are both headline through Florida’s Legislature. If passed, this would increase the income eligibility requirements for families applying for Florida KidCare, allowing families to make more money and still qualify for reasonable monthly rates.
As the rule stands now in Florida, even one dollar over the income threshold and families will may hundreds more per month,
“It’s a pretty dramatic change from $20 a month to $230 a month per child,” Hall said.
For now, a family of four can make up to $52,400 per year and still qualify for subsidized rates through Florida KidCare.
ABC Action News reached out to Healthy Kids, a Florida KidCare partner that helps determine income eligibility for non-Medicaid families.
“Healthy Kids strives to provide the highest quality health insurance, tailored to meet the unique needs of kids as they grow,” said Ashley Carr, a spokesperson for Healthy Kids. “In addition to the subsidized coverage provided for families at specific income levels, we have also chosen to offer competitively priced ‘full-pay’ coverage to families whose income exceeds the subsidy cut-offs set in law.”
Carr also said families save even with the full-pay plan.
“Our full-pay plan oftentimes generates hundreds of dollars in savings to families currently paying higher prices for employer-based family insurance plans,” Carr said. “In fact, legislation was recently passed at the state and federal level to ensure that these full-pay families have the same comprehensive, affordable benefits as our subsidized families – a measure that greatly reduced full-pay out-of-pocket costs.”
"We continually look for ways to generate efficiencies and cost savings for the Florida families we serve, and we greatly appreciate the feedback of advocates. We will work alongside the advocate community, as well as the legislature, in generating ideas to further our collective goals of value and quality,” Carr said.
The Family Healthcare Foundation said if the full-pay rate is still too high, please contact them to review and double-check your income eligibility and application. Often, they can help you find a lower rate on the Health Insurance Marketplace.
They are now working with Stanton’s family and she is now optimistic they will find her a reduced rate.